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What Can Hand Hygiene Learn From Fire Safety?

February 25, 2014

stopcleanyourhands resized 600Hand Hygiene is one of the simplest yet most important things that anyone can do to help keep themselves and others around them healthy and free from disease.


Why, then, do we seem to have such a hard time getting people to pay attention to this?  What if something like fire safety was treated as nonchalantly as hand hygiene? 


Fire is dangerous. It’s also tremendously important, after all without combustion our cars wouldn’t move, our satellites wouldn’t launch and our food would be pretty difficult to cook. Humankind and the environments we build are vulnerable to and even exacerbate the effect of the uncontrolled spread of flames.


How do we work with – and not overly fear – such a dangerous yet important phenomena?


Firstly, we’ve studied it and educated ourselves. We know very well what conditions make fire a threat (i.e. playing with matches) due to many, many years of learning, and have also figured out what to do when it becomes a threat (i.e. use a fire extinguisher). We don’t fear what we understand.


Secondly, the infrastructure is there to support people in not only putting out fires, but more importantly in preventing them. The aforementioned fire extinguisher technology is only one of many examples, but you also have Fire Control Professionals (fire fighters), construction codes that enforce best practices, and alarm systems. There has been much ingenuity, entrepreneurship, collaboration between industries, and public investment in systems that make fire less of a threat than it would be otherwise.


Lastly is the fact that we’ve been successful in getting the public involved through communication. This is where things get truly interesting.


Why don’t you hear of more cases of people accidentally burning things down with a can of hairspray? A simple little symbol makes that risk exceedingly clear. Why do children in elementary school know how to plan something as frightening as a house evacuation? School safety curriculum teaches them. Who can prevent forest fires? Only you can! The big difference here is that it gets the public working together to promote a culture of safety – one that isn’t just watched over and discussed by scholarly gurus, but one owned by all of us and that is a part of our daily life. That’s why we’re rarely nonchalant about fire: we’re all personally involved and invested in its prevention.


What could we possibly learn from fire safety to apply to preventing infections from spreading? Those things aren’t at all alike, are they?


In fact, germs have quite a bit in common with fires.


Germs are dangerous. They’re also tremendously important at times, after all without them we couldn’t make cheese, ferment alcohol or even digest what we eat. Humankind and the environments we build are vulnerable to and even exacerbate the effect of the uncontrolled spread of infection.


We have studies and education to help. Epidemiology is a fascinating and complex branch of medicine, and infection control practices are routinely performed in hospitals the world over. The WHO publishes a guide called the Five Moments of Hand Hygiene, to codify and promote this life-saving behaviour. Epidemiologists and practitioners don’t fear germs because they understand them and how to deal with them.


We also have a very good start to the infrastructure.  There are more types of Alcohol-Based Hand-Rub on the market than one could shake a stick at, perfect for cleaning hands quickly. There are room disinfection robots that attack germs with sanitizer sprays or ultraviolet light. There are even drugs that will clear up most infections (though we can’t rely on antibiotics forever – through over-use we’re speeding up the rate at which the organisms can evolve a resistance to the drugs).


So with all of this, why do we still have to remind people to clean their hands? It’s simple: Unlike with fire safety, most if not all education and infrastructure is targeted at professionals therefore we do not have the public involved in any way that is meaningful. Very few people – many professionals included - practice infection prevention in their daily life like we all do with fire prevention.


Why is this a big deal? The general public has become frightened of outbreaks because they don’t understand infection – most of what the typical person knows comes from drama-and-horror-filled Hollywood films! Infected areas and preventative behaviours in areas-at-risk (such as hospitals) are not clearly marked or otherwise communicated (should I, a hospital visitor or outside contractor, be wearing a mask right now or not?), yet anyone can easily find the nearest fire hose or exit.


So what lessons learned from fire safety can we bring to infection control?


  1. Trust and involve the public. Be honest when infections happen in a clinical or public setting and clearly label infected spaces and required procedures with obvious signs containing iconic symbols and plain language (see #3). In return, this builds trust and reduces fear.
  2. Provide the infrastructure (Hand rub for example), but with the aim of inviting use among and providing education to the general public. Fire extinguishers are available to all in case of fire and provide a quick illustrated education in fire fighting.
  3. Provide visual communications that are well thought-out and which are designed to be instantly understood and recognized, even by someone not entirely familiar with the subject matter. Symbols are a great way of doing this - they cross language barriers AND are successful in getting the public immediately involved. The UN Globally Harmonized System of Classification and Labeling of Chemicals is a great example of this as used currently in hazard labeling. “Clean Your Hands” signs should be as visible, recognizable and well-positioned as “Fire Exit” signs.
  4. Take advantage of Human Factors design in your infection control infrastructure – line-of-sight, readability, accessibility, colour choice, and traffic flow all need to be controlled to encourage use and advertise availability.  Hand hygiene stations need to be as obvious and easy-to-use as fire extinguishers.

So as you can see, there isn’t really that much of a difference between not playing with matches and washing your hands at the correct time.  If safety measures are not performed correctly, the offending party (fire or germs) can multiply and spread in the human environment, causing injury or worse, death.


Getting the public involved makes infection control meaningful to them, which sees them volunteering to be the leaders, enforcers, and practitioners of their own and their neighbors' safety.  Professionals have the time to focus on putting out the big fires, and everyone feels better in knowing that any problem is controllable.  It’s worked in the past with fire safety, and can work to control the spread of infection, too.


About Tagg Design Inc.


Tagg clean handsLeveraging 25 years of sign expertise, Tagg Design is driven towards preventing the spread of infection through the art of communications.

Tagg has recently released their graphical infection control symbols for public use in a downloadable package.  These symbols are freely available for noncommercial use under a creative commons license.


Tagg is active on Twitter (@taggcleanhands) and promotes infection control communication, design (human factors, accessibility, graphics) and the use of social media in healthcare.  Please connect via email (, Facebook and on the web at & for more information.

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